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. 2022 Jul 14:14:2193-2202.
doi: 10.2147/CMAR.S368366. eCollection 2022.

Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Jiao Xue  1 , Qing-Xia Wang  1 , Huan-Ming Xiao  2 , Mei-Jie Shi  2 , Yu-Bao Xie  2 , Sheng Li  2 , Ming Lin  2 , Xiao-Ling Chi  2
Affiliations

Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Jiao Xue et al. Cancer Manag Res. .

Abstract

Purpose: Both metabolic dysfunction-associated fatty liver disease (MAFLD) and hepatitis B virus (HBV) are risk factors for hepatocellular carcinoma (HCC). Although concurrent MAFLD is common in patients with HBV-related HCC, whether MAFLD increases the risk of poor prognosis in patients with HBV-related HCC remains unclear. This study aimed to investigate the impact of MAFLD on prognosis in patients with HBV-related HCC.

Patients and methods: In this retrospective cohort study, 549 patients with HBV-related HCC were enrolled from January 2010 to April 2020 in Guangdong Provincial Hospital of Chinese Medicine, including 169 patients with MAFLD (MAFLD group) and 380 patients without MAFLD (Non-MAFLD group). Propensity score matching (PSM) analysis was performed to balance the baseline characteristics. Kaplan-Meier survival curves were performed to compare the prognosis between the two matched groups. A multivariate Cox proportional hazards model was used to determine the risk factors for poor prognosis.

Results: The median follow-up time for all patients was 20 (interquartile range 8-40) months. We found concurrent MAFLD was associated with a significantly decreased PFS rate before and after PSM analysis. The 1-year, 2-year, and 3-year PFS rates for the MAFLD and Non-MAFLD groups after PSM were 61.3% and 70.8%, 43.9% and 54.5%, 31.1% and 41.8%, respectively. Cox multivariable analysis showed that concurrent MAFLD was an independent risk factor for poor prognosis (death or progression) (HR = 1.49, P = 0.001). More interestingly, the risk of poor prognosis was significantly higher in the MAFLD subtype with metabolic components ≥2 compared to those with metabolic components <2 (HR = 1.97, P < 0.001).

Conclusion: Concurrent MAFLD was associated with a higher risk of poor prognosis in patients with HBV-related HCC, especially MAFLD with metabolic components ≥2.

Keywords: hepatitis B virus; hepatocellular carcinoma; metabolic dysfunction-associated fatty liver disease; poor prognosis.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of this study.
Figure 2
Figure 2
Survival analysis among HBV-related HCC patients with and without MAFLD before and after PSM analysis. The Kaplan–Meier curves indicated that the progression-free survival rates for the MAFLD group were lower than those in the Non-MAFLD group both before PSM analysis ((A), P=0.008) and after PSM analysis ((B), P=0.044).
Figure 3
Figure 3
Survival analysis among HBV-related HCC patients in MAFLD subgroup. The Kaplan–Meier curves indicated that the progression-free survival rates for the MAFLD subtype with metabolic components ≥2 were lower than those with metabolic components<2.
See this image and copyright information in PMC

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